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Probable Human to Human Transmission of H5N1 in Indonesia
July 15, 2005
"These are suspected bird flu cases," Supari said at a news conference attended by World Health Organization officials. "We have sent specimens to Hong Kong to confirm the results, which will take seven to 10 days."
The above comments confirm earlier reports that the three familial deaths in Indonesia are due to human-to-human transmission of H5N1 bird flu. The initial report was quickly followed by misinformation, which at bests were errors. It seems that there were signs of H5N1, in contrast to media comments following the initial story. The initial denials were coupled with more misinformation on travel history which included comments about India, Hong Kong, and Hungary. It seems that the major relevant fact was the lack of contact with poultry.
As suspected, there was a bimodal distribution on onset dates, suggesting human-to-human transmission. Virtual all familial clusters in Vietnam and Thailand show this bimodal distribution, indicating human-to-human transmission.
The misinformation by Indonesia is coupled with misinformation by the WHO. Both Nature and Science have recently indicate WHO is providing misinformation of the stage of the pandemic, which is listed a stage three. Clearly the small clusters of human cases have been reported since the beginning if 2004 in the form of familial clusters. These clusters grew larger in 2005, particularly in northern Vietnam, moving the pandemic to stage 5. These clusters are of confirmed cases. The milder cases indicate the clusters are larger than reported in the WHO official list.
Now that human-to-human transmission now appears likely in yet another country, it is time for the WHO to stop issuing statements that violate their definition of a flu pandemic.
The real question on the pandemic stage is if it is a stage 5 or stage 6, which would be supported by boxun reports on human cases in Qinghai China.